SPINAL STABILIZATION SYSTEM WITH FLEXIBLE GUIDES
In one embodiment, a spinal stabilization apparatus includes a vertebral anchor having a head portion and a bone attachment portion. An elongate, flexible guide is removably coupled to the head portion of the vertebral anchor and has a channel extending longitudinally thereof and communicating with a slot in the head portion of the anchor. An elongate cord may be received within the channel to facilitate inserting and securing a spacer between pairs of anchors installed into adjacent vertebrae of a person's spine.
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This application is a continuation of U.S. application Ser. No. 11/539,287, filed on Oct. 6, 2006, which is incorporated herein by reference.
TECHNICAL FIELDThe present invention relates generally to spinal support devices, and more particularly to devices that facilitate installing an implantable system for providing dynamic stability of a person's spine.
BACKGROUND OF THE INVENTIONThe treatment of acute and chronic spinal instabilities or deformities of the thoracic, lumbar, and sacral spine has traditionally involved the implantation of rigid rods to secure the vertebrae of a patient. More recently, flexible materials have been utilized in connection with securing elements, such as pedicle screws, to provide a dynamic stabilization of the spine. Such dynamic stabilization systems typically include a flexible spacer positioned between pedicle screws installed in adjacent vertebrae of person's spine. Once the spacer is positioned between the pedicle screws, a flexible cord is threaded through eyelets formed in the pedicle screws and an aperture through the spacer. The flexible cord retains the spacer between the pedicle screws while cooperating with the spacer to permit mobility of the spine. One drawback of traditional implantation of such dynamic stabilization systems is that relatively large surgical sites are required to permit threading the cord through the screws and spacer once the spacer has been positioned between the screws.
While some dynamic stabilization systems have been proposed for permitting the top loading of a spacer and cord between pedicle screws using guide rods to direct the cord and spacer between the screws, these systems also require a relatively large surgical sites and present difficulties when the curvature of the spine causes a convergence of the guide rods that makes it difficult to position the spacer between the guide rods.
A need therefore exists for a spinal dynamic stabilization system that overcomes these and other drawbacks of the prior art.
SUMMARY OF THE INVENTIONThe present invention overcomes the foregoing and other shortcomings and drawbacks of spinal stabilization systems heretofore known for use in suitable various commercial and industrial environments. While various embodiments will be described herein, it will be understood that the invention is not limited to these embodiments. On the contrary, the invention includes all alternatives, modifications and equivalents as may be included within the spirit and scope of the present invention.
In one embodiment, a spinal stabilization apparatus includes a vertebral anchor having a head portion and a bone attachment portion. A slot in the head portion has an open end opposite the bone attachment portion. The apparatus further includes an elongate, flexible guide removably coupled to the head portion of the vertebral anchor. A longitudinally extending channel in the guide communicates with the slot in the head portion of the anchor, through the open end thereof.
The apparatus may further include an elongate, flexible cord sized to be received in the channel. The cord may thereby be directed along the channel and received within the slot of the head portion. A securing member may be coupled to the head portion to retain the cord within the slot. The securing member may be carried on a portion of the guide until it is needed to secure the cord within the slot.
In another embodiment, the flexible guide may be formed from polymeric material. The polymeric material may be integrally molded to the head of the vertebral anchor, or it may be molded separately and thereafter secured to the head of the vertebral anchor. In yet another embodiment, at least part of the guide proximate the head portion of the vertebral anchor is non-polymeric, while the rest of the guide comprises polymeric material.
In another embodiment, an implantable spinal apparatus includes first and second vertebral anchors, each comprising a head portion and a bone attachment portion. Elongate, flexible guides are removably coupled to the head portions of respective anchors. Each guide includes a channel extending longitudinally thereof and communicating with a slot formed in the head portion of the respective anchor. An elongate, flexible cord extends through the channels of the guides and through a spacer disposed between the guides. The cord and spacer may be directed along the guides and the cord may be received within the slots to position the spacer between the vertebral anchors. The apparatus further includes securing members associated with the vertebral anchors for retaining the cord within the slots of the respective anchors.
In yet another embodiment, a method of stabilizing a spine through an incision includes securing at least first and second anchors to respective first and second vertebrae, coupling a spacer to an elongate cord, directing the cord between guides extending from the anchors, flexing the anchors to receive the spacer therebetween, directing the cord and spacer along the guides to an installation position between the anchors, and removing the guides from the anchors.
These and other features, objects and advantages of the invention will become more readily apparent to those skilled in the art in view of the following detailed description, taken in conjunction with the accompanying drawings.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the general description of the invention given above, and the detailed description given below, serve to explain the principles of the invention.
An elongate guide 18 is removably secured to the head portion 28 of the pedicle screw 12 and is formed substantially from a resilient, flexible material that permits deformation or bending of the guide 18 along its length without transmitting significant force to the pedicle screw 12. For example, the guide 18 may be formed from polymeric material such as nylon, polyethylene, polyurethane, or various other polymeric materials which are biocompatible and provide sufficient flexibility to permit the guides to bend in flexure along their length without transmitting significant force to the pedicle screw 12. In the embodiment shown, the guide 18 includes a longitudinal channel 40 extending from a first end 42 toward a second end 44 of the guide 18. The channel 40 has an opening 46 at the first end 42 that is shaped to mate with the head 28 of the pedicle screw 12 such that the channel 40 communicates with the slot 32 formed in the head 28 of the pedicle screw 12. In this arrangement, the longitudinally extending channel 40 may be used to guide a flexible cord 26 from the second end 44 of the guide 18, along its length, and into the slot 32 formed in the head 28 of the pedicle screw 12.
In one embodiment, the guide 18 is integrally molded onto the head 28 of the pedicle screw 12. Mating surfaces between the pedicle screw and the guide are configured to provide a mechanical interlock that is sufficient to withstand forces applied to the guides 18 during installation of the pedicle screws 12 into the vertebrae 14, 16 and installation of the spacer 26 between adjacent pedicle screws 12. However, the guides 18 may be removed from the heads 28 of the pedicle screws 12, for example, by application of an appropriate force or by manipulating the guide 18 relative to the pedicle screw 12, to cause the guide 18 to become separated from the head 28 of the pedicle screw 12. The guide 18 may be integrally molded onto the head 28 of the pedicle screw 12, for example, by a molding process wherein the pedicle screw 12 is placed into a mold and the material forming the guide 18 is injected or otherwise transferred into an adjacent cavity to form the guide 18 directly onto the head 28 of the pedicle screw 12. Alternatively, the guide 18 may be formed in a molding process without the pedicle screw 12, and may thereafter be joined to the head 28 of the pedicle screw 12 by bonding or mechanically interlocking the guide 18 onto the head 28 the pedicle screw 12.
With continued reference to
While the securing member 72 has been shown and described herein as comprising a set screw, it will be recognized that various other types of securing members may alternatively be used to secure the cord 26 to the head 28 of an anchor 12. Likewise, in place of aperture 70, the guide 18 may be configured to accommodate these various other types of securing members and to retain them until it is desired to engage the securing member 72 with the anchor 12.
In another exemplary embodiment, a guide may be configured as a composite structure, comprising a first portion formed from a substantially rigid material and a second portion comprising a flexible material. In the embodiment shown in
Referring now to
With the spacer 24 positioned between the guides 18 and the cord 26 extending through the respective channels 40, as illustrated in
While the present invention has been illustrated by the description of one or more embodiments thereof, and while the embodiments have been described in considerable detail, they are not intended to restrict or in any way limit the scope of the appended claims to such detail. Additional advantages and modifications will readily appear to those skilled in the art. The invention in its broader aspects is therefore not limited to the specific details, representative apparatus and method and illustrative examples shown and described. Accordingly, departures may be made from such details without departing from the scope or spirit of the general inventive concept
Claims
1. A spinal stabilization apparatus, comprising:
- a vertebral anchor comprising a head portion and a bone attachment portion;
- a slot in said head portion, said slot having an open end opposite said bone attachment portion;
- an elongate flexible guide removably coupled to said head portion of said vertebral anchor and adapted to extend percutaneously from a surgical site; and
- a channel in said guide, said channel extending longitudinally of said guide and communicating with said slot through said open end.
2. The apparatus of claim 1, further comprising:
- an elongate flexible cord having an outer circumference sized to be received within said channel for movement therealong and into said slot through said open end.
3. The apparatus of claim 2, further comprising:
- a securing member configured to be coupled to said head portion and to retain said cord within said slot when coupled thereto.
4. The apparatus of claim 3, wherein:
- said head portion includes internal threads proximate said open end; and said securing member is a set screw having external threads corresponding to said internal threads of said head portion.
5. The apparatus of claim 3, wherein said securing member is removably carried on said guide prior to engagement with said head portion.
6. The apparatus of claim 5, wherein said channel of said guide is adapted to direct said securing member along said channel for engagement with said head portion.
7. The apparatus of claim 1, wherein said guide comprises polymeric material.
8. The apparatus of claim 7 wherein said polymeric material is integrally molded onto said head portion.
9. The apparatus of claim 7 wherein said polymeric material is adhesively bonded to said head portion.
10. The apparatus of claim 7, wherein at least part of said guide proximate said head portion comprises non-polymeric material.
11. The apparatus of claim 10, wherein said non-polymeric portion of said guide is removably coupled to said head portion.
12. The apparatus of claim 10, wherein:
- said head portion includes first screw threads proximate said open end; and
- said non-polymeric portion of said guide includes second screw threads complementary to said first screw threads of said head portion, said first and second screw threads cooperating to removably couple said guide to said head portion.
13. The apparatus of claim 2, further comprising: a spacer removably received on said cord.
14. An implantable spinal apparatus, comprising:
- at least first and second vertebral anchors, each said vertebral anchor comprising a head portion and a bone attachment portion;
- each said head portion including a slot having an open end opposite said bone attachment portion;
- a plurality of elongate flexible guides, each guide associated with one of said vertebral anchors and removably coupled to said head portion of said respectively associated vertebral anchor;
- each said guide including a channel extending longitudinally of said guide and communicating with said slot of said respective vertebral anchor through said open end of said head portion;
- an elongate flexible cord having an outer circumference sized to be received within said channels of said guides for movement therealong and into said slots of said vertebral anchors through said respective open ends of said head portions;
- a spacer removably received on said cord; and
- a plurality of securing members, each securing member associated with one of said vertebral anchors and configured to be coupled to said respective head portion and to retain said cord within said respective slot.
15. A method of stabilizing a spine through an incision, comprising:
- securing at least first and second anchors to respective first and second vertebrae, each anchor having a head and an elongate, flexible guide extending from the head outwardly of the incision;
- coupling a spacer to an elongate cord;
- directing the cord between the guides;
- flexing the guides to receive the spacer therebetween;
- directing the cord and spacer along the guides to an installation position between the heads of the anchors; and
- removing the guides from the heads of the anchors.
16. The method of claim 15, further comprising:
- securing the cord to the heads of the anchors.
17. The method of claim 16, wherein securing the cord comprises threadably engaging a securing member to the respective anchor heads.
18. The method of claim 17 further comprising directing the securing members along the guides to engage the heads of the anchors.
Type: Application
Filed: May 29, 2008
Publication Date: Sep 18, 2008
Patent Grant number: 7744629
Applicant: Zimmer Spine, Inc. (Minneapolis, MN)
Inventors: Hugh Hestad (Edina, MN), Mark Rice (Minneapolis, MN)
Application Number: 12/128,721
International Classification: A61B 17/70 (20060101); A61B 17/04 (20060101);